The nurse is teaching a client with a new diagnosis of type 1 diabetes about insulin aspart (NovoLog). Which of the following instructions should the nurse include?
- A. Take the insulin 30 minutes before meals.
- B. Mix the insulin with other insulins in the same syringe.
- C. Report any sweating or shakiness.
- D. Store the insulin at room temperature.
Correct Answer: C
Rationale: Sweating or shakiness indicate hypoglycemia, requiring reporting with insulin aspart. Options A, B, and D are incorrect.
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A 52-year-old woman has an appendectomy for a ruptured appendix. The nurse observes a student nurse perform a wet-to-dry dressing change on the 2-in incision.
Which of the following behaviors, if performed by the student nurse, would require an intervention by the nurse?
- A. The old dressing is saturated with sterile saline before it is removed.
- B. Dry dressings are placed over the saline-saturated gauze in the incision.
- C. Wound debris and necrotic tissue are removed with the old dressing.
- D. The gauze is saturated with sterile saline before it is packed into the incision.
Correct Answer: A
Rationale: Strategy: 'Require an intervention' indicates an incorrect action. (1) correct-should be removed dry so wound debris and necrotic tissue are removed with old dressing (2) done to protect clothing and bedding (3) purpose of wet-to-dry dressing (4) appropriate procedure
A baby girl is born with a meningomyelocele. To prevent trauma to the sac, the nurse should place the infant:
- A. Supine and flat
- B. Prone with the hips slightly elevated
- C. Prone with the head slightly elevated
- D. Side lying
Correct Answer: B
Rationale: Placing the infant prone with hips slightly elevated protects the meningomyelocele sac from trauma and pressure.
The nurse is preparing a client with a severe case of inflamed hemorrhoids for a rectal examination by the physician. What is the best position to place her in on the examination table?
- A. Dorsal recumbent
- B. Knee-chest
- C. Sims'
- D. Lithotomy
Correct Answer: B
Rationale: The knee-chest position provides optimal exposure for rectal examination, minimizing discomfort with inflamed hemorrhoids.
The nurse is caring for a client with asthma who has developed gastroesophageal reflux disease (GERD). Which of the following medications prescribed for the client may aggravate GERD?
- A. Anticholinergics
- B. Corticosteroids
- C. Histamine blocker
- D. Antibiotics
Correct Answer: A
Rationale: An anticholinergic medication will decrease gastric emptying and the pressure on the lower esophageal sphincter.
The physician has ordered Prednisone 50 mg daily to promote diuresis in a client with nephrotic syndrome. The nurse should administer the medication:
- A. In a single dose at bedtime
- B. With a snack or glass of milk
- C. With water to promote absorption
- D. Prior to arising in the morning
Correct Answer: B
Rationale: Prednisone, a steroid, should be given with a snack or meal to prevent gastric irritation. Answer C would cause pain and gastric upset, making it incorrect. Answers A and D do not include providing food with the medication, so they are incorrect.
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